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Biomedical subjects

H Karle

Publications and source records attributed to H Karle.

At least 19 recordsLinked to original sources
PubMed1997

[Hemoglobinopathy in the county of Copenhagen].

In Copenhagen County, haemoglobinopathy was centralized to the Department of Haematology L, Herlev University Hospital from January 1995. All pregnant women of relevant ethnic origin admitted to the obstetric departments of the Country in 1995, were examined by haemoglobin electrophoresis. furthermore, we performed haemoglobin electrophoresis on immigrants admitted on suspicion of haemoglobinopathy. 24 (4.8%) of 505 examinations in pregnant women were abnormal. 12 reflected a carrier condition for either beta-thalassaemia or sickle cell disease; 53 of 82 examinations in non-pregnant patients were abnormal; 29 had beta-thalassaemia minor and the rest included the haemoglobin variants C, D, E, H and S, mostly in a heterozygous from. The genetic lesions, all of which were mutations, were characterized by molecular genetic analysis in 13 cases with demonstrated beta-gene disorder. The gene frequency of haemoglobinopathies among immigrants to Denmark is common. The Danish health care system must therefore be prepared to address this problem including the clinical aspects, screening and molecular biological examinations, prenatal diagnosis and genetic counselling.

Adult↗
PubMed1997

Chemotherapy-related - late occurring - Philadelphia chromosome in AML, ALL and CML. Similar events related to treatment with DNA topoisomerase II inhibitors?

Therapy with DNA topoisomerase II inhibitors has been shown to result in an increased risk of acute myeloid leukemia (AML), often presenting balanced translocations to chromosome bands 11q23 and 21q22. Also other balanced aberrations, more rarely observed in therapy-related AML (t-AML), such as t(15;17) and inv(16) have been associated with these drugs. Recently we observed a case of chronic myeloid leukemia (CML) with t(9;22) after therapy of a germ cell tumor with etoposide, cisplatin and bleomycin. Based on this case and a review of chemotherapy-related leukemias with t(9;22) from the literature, we suggest a causal relationship between therapy with DNA topoisomerase II inhibitors and development of various types of leukemia carrying the Philadelphia chromosome.

Adolescent↗
PubMed1995

[Shore-term stimulation with myeloid growth factors expands bone marrow hematopoiesis. A magnetic resonance spectroscopic study].

The present study is intended to investigate the expansion of haematopoiesis by localised volume selective proton magnetic resonance spectroscopy (MRS) during treatment with myeloid growth factors. Six consecutive patients were treated with daily subcutaneous injections of recombinant human granulocyte colony-stimulating factor (rhG-CSF, n = 2) or granulocyte-macrophage colony-stimulating factor (rhGM-CSF, n = 4) for five days before marrow harvest. MRS investigations were performed prior to treatment (day 0), day 5 and day 12. The patients responded with a rise in blood absolute neutrophil count from median 3.3 x 10(9)/l (range 1.3-7.3 x 10(9)/l) before to 15.6 x 10(9)l (range 6.8-22.0 x 10(9)/l) after treatment. Concomitantly an increase in bone marrow cellularity and myeloid:erythroid ratios documented the stimulation of myelopoiesis. During priming, the light-density cell proliferation rate in marrow samples increased from median 21.9 (range 4.5-31) x 10(3) cpm to 54.7 (range 13.9-94) x 10(3) cpm and the total number of myeloid progenitors enumerated as day 7/14 GM-CFUs per volume aspirated marrow increased from median 11/8 x 10(3) (range 4.0-87.5/2.2-103.0) to 64/76. x 10(3) (range 28.4-1180.6/23.2-2850.0). MRS detected a significant increase in bone marrow "relative water content" day 12, one week after myeloid growth factor treatment was stopped, from median 30.5% (range 16-45) to 79% (range 56-93) (p < 0.05). Haematopoiesis was concommittantly detected in new areas of femur.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Hemoglobinopathies. Current therapeutic possibilities].

In recent years, the number of immigrants has increased considerably in Denmark. Consequently, a series of new clinical pictures has appeared in the Danish health care system. Typical examples are the genetic diseases, the haemoglobinopathies. Most of the immigrants come from areas, where the gene frequency of these disorders is widely distributed, for instance the Mediterranean countries, the Middle East, Southeast Asia and Africa. Most frequent are the heterozygous thalassaemias, but also the number of patients with severe thalassaemia and other clinically important haemoglobinopathies such as sickle cell anaemia has also increased in recent years. The clinical problems concerning these patients focus on two important topics, namely genetic counselling of heterozygous individuals (in some cases combined with prenatal diagnostics) and the treatment of patients with clinically severe haemoglobinopathy. The only curative treatment of the haemoglobinopathies is allogeneic bone marrow transplantation, but this treatment can only be offered to a few of these patients. However, a variety of therapeutic options exist which can improve their prognosis and quality of life. Since the number of patients with these diseases will probably increase over the next years we find it relevant, based on typical case stories, to give a review of the present therapeutic possibilities for these disorders.

Adult↗
PubMed1995

Comprehensive evaluation of specialist training: an alternative to board examinations in Europe?

Demands for specialist examinations grow in a new Europe with open borders for labour force, including medical doctors. Significant mechanisms stimulating this development are outlined. In the light of an analysis of the purpose of evaluation of postgraduate medical education, a warning is expressed against simplistic approaches and solutions. The measurement of clinical competence is complex and requires clarification of concepts, unveiling of needs, understanding of methodology, acceptance of consequences, and consideration of resource aspects of the different types of evaluation available. In order to emphasize the educational purpose of specialist training, a comprehensive formative evaluation process is suggested as an alternative to specialist examinations. This should involve both the trainee and the institution. Europe should not automatically imitate North America, and a supernational examination system with its many pedagogical, methodological, legal, and resource problems may not be the right approach to the assurance of quality in postgraduate medical education in Europe.

Education, Medical↗
PubMed1995

[Future collaboration in medical education in Scandinavia].

The Nordic Federation for Medical Education is in the process of re-organisation. Owing to increasing cooperation with the remainder of Europe, it is desirable that the Nordic countries unite to preserve the structure of Nordic medical education.

Education, Medical↗
PubMed1994

[Renaissance of the reticulocyte].

Flowcytometric enumeration of reticulocytes using RNA-binding fluorochromes, a method both sensitive and reproducible, is rapidly gaining ground. It performs conspicuously better than the traditional manual method of reticulocyte counting, which is unacceptably inaccurate. The reticulocyte count is a valuable indicator of erythropoietic activity, of essential importance in discerning between the aregeneratory anaemias and anaemias accompanied by an adequate, partial or complete compensatory erythropoietic response. The reticulocyte count can be applied to the monitoring of the response to treatment including both allogeneic and autologous bone marrow transplantation, as well as to the evaluation of the response to recombinant human growth factors. The mean fluorescence intensity of reticulocytes enumerated by the flowcytometric analysis, is a variable possessing an independent clinical value for calculation of a reticulocyte production index and an erythropoiesis index.

Flow Cytometry↗
PubMed1994

Short-term myeloid growth factor mediated expansion of bone marrow haemopoiesis studied by localized magnetic resonance proton spectroscopy.

Previously we have shown that short-term myeloid growth factor priming of haemopoiesis prior to bone marrow harvest increased the yield of myeloid progenitors in the graft. The present study is intended to investigate the expansion of haemopoiesis by volume selective proton magnetic resonance spectroscopy (MRS). Six patients were treated with daily subcutaneous injections of recombinant human granulocyte colony-stimulating factor (rhG-CSF, n = 2) or granulocyte-macrophage colony-stimulating factor (rhGM-CSF, n = 4) for 5d before marrow harvest. MRS investigations were performed prior to treatment (day 0), day 5 and day 12. Spectroscopic examinations were performed with the stimulated echo acquisition mode (STEAM) method on a 1.5 T clinical whole-body imaging unit. A cubic volume of interest (VOI) was selected in the bone marrow of the left iliac bone. The patients responded with a rise in blood absolute neutrophil count from median 3.3 x 10(9)/l (range 1.3-7.3 x 10(9)/l) before to 15.6 x 10(9)/l (range 6.8-22.0 x 10(9)/l) after treatment. Concomitantly an increase in bone marrow cellularity and myeloid:erythroid ratios documented the stimulation of myelopoiesis. During priming, the light-density cell proliferation rate in marrow samples increased from median 21.9 (range 4.5-31) x 10(3) cpm to 54.7 (range 13.9-94) x 10(3) cpm and the total number of myeloid progenitors enumerated as day 7/14 GM-CFUs per volume aspirated marrow increased from median 11/8 x 10(3) (range 4.0-87.5/2.2-103.0) to 64/76 x 10(3) (range 28.4-1180.6/23.2-2850.0). MRS detected a significant increase in bone marrow 'relative water content' day 12, 1 week after myeloid growth factor treatment was stopped, from median 30.5% (range 16-45) to 79% (range 56-93). In parallel, haemopoiesis was detected in new areas of femur. In conclusion, the non-invasive MRS method may be a useful and reliable in vivo examination for expansion of haemopoiesis and a correspondent reduction of fat tissue in bone marrow after priming with recombinant human haemopoietic growth factors.

Adult↗